Congenital amputation

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Please improve this article if you can. (November 2007)

Congenital amputation is a congenital disorder caused by fibrous bands of the amnion that constrict foetal limbs to such an extent, that they fall off due to missing blood supply. The child is born without one or more limbs or without parts of limbs (amelia).

[edit] Causes

The inner fetal membrane (amnion) ruptures without injury to the outer membrane (chorion). Fibrous bands from the ruptured amnion float in the amniotic fluid and can get entangled with the fetus, thus reducing blood supply to the developing limbs to such an extent, that the limbs can become strangulated, the tissues die and are absorbed into the amniotic fluid. Amnion ruptures can be caused by:

teratogenic drugs (e.g. thalidomide, which causes phocomelia), or environmental chemicals
ionizing radiation (atomic weapons, radioiodine, radiation therapy)
infections
metabolic imbalance
trauma

[edit] Treatment

In rare cases, if diagnosed in utero, fetal surgery may be considered to save a limb which is in danger of amputation.

[edit] Literature

Gabos PG. (Department of Orthopedic Surgery, Alfred I. duPont Hospital for Children, Wilmington, DE 19899, USA) Modified technique for the surgical treatment of congenital constriction bands of the arms and legs of infants and children Orthopedics. 2006 May;29(5):401-4
Walter JH Jr, Goss LR, Lazzara AT. (Department of Orthopedics, Pennsylvania College of Podiatric Medicine, Philadelphia 19107, USA.) Amniotic band syndrome J Foot Ankle Surg. 1998 Jul-Aug;37(4):325-333
Light TR, Ogden JA. (Dept. of Orthopaedic Surgery, Loyola University School of Medicine, Maywood, Illinois 60153, USA) Congenital constriction band syndrome. Pathophysiology and treatment Yale J Biol Med. 1993 May-Jun;66(3):143-155
Further literature available e.g. via PubMed, free medical literature database of the US health authority (search for: congenital amputation or amniotic band or congenital constriction bands or other synonyms) via http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed